HARARE, 17 August 2009 (IRIN) - Industrial action for better wages by Zimbabwe's doctors is threatening the country's ability to deal with H1N1 influenza, also known as swine flu, and the possible resurgence of a deadly cholera epidemic.

Public hospital doctors have been on strike for the past two weeks, demanding housing and car allowances and a salary of US$1,000 - a sharp rise from the uniform US$170 monthly salary paid to all public servants.

Zimbabwe's public health system is under severe pressure: general nutrition levels are poor - around 7 million people were receiving food aid at the beginning of 2009 and many are still food insecure; a cholera epidemic that began in August 2008 and lasted almost a year recorded nearly 100,000 cases and claimed more than 4,000 lives. Now, reports of H1N1 cases are increasing.

The cholera outbreak, Africa's most deadly in 15 years, was blamed on the breakdown of water and sanitation infrastructure, which in the main has not been repaired and analysts acknowledge will provide a breeding ground for the waterborne disease.

A recent visit by an IRIN correspondent to Parirenyatwa hospital in the capital, Harare, the country's largest referral facility, established that patients were being turned away because there were no doctors available.

When the unity government was established in February 2009 the public health service was on the verge of collapse, with most government hospitals closed because of staff absenteeism and acute shortages of medical equipment and drugs.

Resurrection of the health service was made a priority, but recovery is being dented by the doctor's strike, and compounded by a "go-slow" by nursing staff, who are also threatening to strike if their working conditions do not improve.

"The strike will have a negative bearing on our efforts to revive the health sector. We are appealing to the health workers to bear with us while we negotiate for better salaries for them. The government has no financial resources," Health and child welfare minister Henry Madzorera told IRIN.

International donors have been cautious to respond to the unity government's appeal for more than US$8 billion to kick-start the beleaguered economy, adopting a wait-and-see approach to the uneasy marriage between President Robert Mugabe's ZANU-PF and Prime Minister Morgan Tsvangirai's Movement for Democratic Change (MDC).

Cholera and H1N1 must be taken seriously

"The government is not being serious about the potential threat of swine flu and cholera outbreak. Only emergency cases are being attended to, while outpatient departments have been closed," said Brighton Chizhande, president of the Zimbabwe Hospital Doctors Association.

However, Health Services Board executive chairman Lovemore Mbengeranwa told the parliamentary portfolio committee on health that most of the doctors' grievances were being addressed and they would return to work soon.

MDC spokesman Luke Tamborinyoka told IRIN: "There is an urgent need for the government to avert this strike, as it comes when the country is still recovering from a serious outbreak of cholera."

He noted that "Although doctors are at the centre of the health recovery process and any strike action is likely to have a negative effect, the MDC calls on the government to give a living wage, considering the amount of work and sacrifice they put in saving the lives of the people."

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